초록접수 현황
| 16F-106 | 포럼 발표 |
Late Improvement of Echocardiographic Parameters after Extended Pericardiectomy for Constrictive Pericarditis
Min Soo Kim M.D.¹, Min Suk Choi M.D.², Pyo Won Park M.D. Ph.D.¹, Wook Sung Kim M.D. Ph.D.¹, Kiick Sung M.D. Ph.D.¹, Young Tak Lee M.D. Ph.D.¹, Ji-Hyuk Yang M.D. Ph.D.¹, Tae-Gook Jun M.D. Ph.D.¹, Yang Hyun Cho M.D. Ph.D.¹, Dong Seop Jeong M.D. Ph.D.¹
¹Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea, ²Department of Thoracic and Cardiovascular Surgery, Eulji University Hospital, Eulji University College of Medicine, Daejeon, Korea
Background : Pericardiectomy is the definite treatment for constrictive pericarditis. The echocardiographic characteristics of constrictive pericarditis have been described in many studies. However, the serial changes after pericardiectomy rarely have been reported. In this study, we have analyzed the echocardiographic changes after Pericardiectomy and compared the results between two groups according to the extent of pericardiectomy.
Methods : 90 consecutive constrictive pericarditis patients who underwent pericardiectomy between February 2005 and April 2015 were included in this study. The patients were divided into conventional (n=37) and extended groups (n=53) according to the extent of pericardiectomy. The preoperative, immediate postoperative and the most recent echocardiographic parameters were analyzed and compared. The median follow-up duration was 37.6 months.
Results : Early mortality was 4.4% (4/90) and late mortality was 4.7% (4/86). 10-year survival rates were 70.3±12.3% in the conventional group and 95±4.9% in the extended group (p=0.008 by log-rank test). The echocardiographic parameters improved for both groups as the ratio of lateral to medial peak early diastolic velocity of the mitral annulus (e’) was increased, the respiratory variation of mitral inflow was decreased and annulus reversus was disappeared. Improvements in such parameters were not distinctive in immediate postoperative echocardiographic findings, but the extended group showed markedly better improvement on the echocardiographic parameters for the most recent examination. The figures attached below are the box and whisker plots about serial changes of the ratios of e’lateral to e’medial in the preoperative, immediate postoperative and the last echocardiography results which show markedly better improvement for the extended group. Also, decreased right ventricular systolic pressure and disappearance of pericardial thickening were only evident in the extended group.
Conclusion : Extended pericardiectomy which removes additional pericardium posterior to phrenic nerve showed better improvement of echocardiographic parameters on the serial echocardiographic examinations compared to conventional pericardiectomy.
Methods : 90 consecutive constrictive pericarditis patients who underwent pericardiectomy between February 2005 and April 2015 were included in this study. The patients were divided into conventional (n=37) and extended groups (n=53) according to the extent of pericardiectomy. The preoperative, immediate postoperative and the most recent echocardiographic parameters were analyzed and compared. The median follow-up duration was 37.6 months.
Results : Early mortality was 4.4% (4/90) and late mortality was 4.7% (4/86). 10-year survival rates were 70.3±12.3% in the conventional group and 95±4.9% in the extended group (p=0.008 by log-rank test). The echocardiographic parameters improved for both groups as the ratio of lateral to medial peak early diastolic velocity of the mitral annulus (e’) was increased, the respiratory variation of mitral inflow was decreased and annulus reversus was disappeared. Improvements in such parameters were not distinctive in immediate postoperative echocardiographic findings, but the extended group showed markedly better improvement on the echocardiographic parameters for the most recent examination. The figures attached below are the box and whisker plots about serial changes of the ratios of e’lateral to e’medial in the preoperative, immediate postoperative and the last echocardiography results which show markedly better improvement for the extended group. Also, decreased right ventricular systolic pressure and disappearance of pericardial thickening were only evident in the extended group.
Conclusion : Extended pericardiectomy which removes additional pericardium posterior to phrenic nerve showed better improvement of echocardiographic parameters on the serial echocardiographic examinations compared to conventional pericardiectomy.
첨부파일 : fig.1.png
책임저자: Dong Seop Jeong
Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
발표자: Min Soo Kim, E-mail : aqms78@naver.com